Aces in Aging: SLUCare Geriatrics

A fall down the stairs. A name you can't quite remember. Chronic fatigue. If you're
70 or older, you need to pay attention to these classic geriatric symptoms, says Dr. John Morley, a SLUCare Physician Group geriatrician and director of Geriatric Medicine at Saint Louis University. "The beauty of early screening is now there are many things
we can do to address issues or slow the onset of geriatric diseases such as Alzheimer's and dementia," he says.

One study showed that less than 10 percent of people with dementia were diagnosed
by their family practitioners.”

Yet patients — and their doctors — might not know what to watch for. "Many people
70 and older pay no attention to whether they have the classic geriatrics symptoms,
which include getting frail, losing muscle and not thinking clearly," Morley says.
"One study showed that less than 10 percent of people with dementia were diagnosed
by their family practitioners."

To help patients identify problems early, Morley and his associates at SLUCare developed
rapid screening tests for frailty and cognitive health, tests now used around the
world. They are straightforward, take less than a few minutes, and can be performed
at home easily. The cognitive test, called the Saint Louis University Mental Status
Examination, is available at aging.slu.edu, while the frailty test asks patients: Are you fatigued? Can you walk up a flight
of stairs? Can you walk a block? Do you have more than five illnesses? Have you lost
more than 5 percent of your weight in the past six months? "Patients with more than
two of these will run into trouble, because those symptoms place you at an increased
risk of death, hospitalization or nursing home placement," Morley says.

We can provide easy-to-handle solutions and recommend simple things that impact patients'
quality of life. We also try to simplify patients' medication plans.”

Patients who score poorly on either test can turn to SLUCare's geriatrics team for
a longer, more comprehensive screening. One major benefit to consulting a geriatrician,
a physician who specializes in symptoms associated with aging, is that he or she is
focused on simplifying care and finding the underlying cause of symptoms, rather than
merely writing another prescription, Morley says. "Geriatricians are focused on comorbidities
and all the things you have to pull together to make an older person function well,"
he says. "We can provide easy-to-handle solutions and recommend simple things that
impact patients' quality of life. We also try to simplify patients' medication plans."

One local man in his 60s recently turned to the SLUCare geriatrics team to find out
what was causing his faulty memory and diminished job performance. When he performed
poorly on the quick cognitive test, Morley asked his wife a series of questions, including
whether the patient snored at night. He discovered the man's issues stemmed from sleep apnea, a disorder that can go undiagnosed for years. "We got him a CPAP mask, and the next
time I saw him, he was back at the ideal score on the cognitive test," Morley says.
For another patient suffering from fatigue, Morley's team discovered the underlying
cause was depression. "We treated the depression, which cured his fatigue," he says. "We've helped many patients get off medication,
improve quality of life, and prolong their independence."